Defining the range of expression, risk factors for, and incidence of FASD in children born to women who drink varying amounts of alcohol during pregnancy is of vital importance in terms of prevention, intervention and treatment. The proposed study entails a collaboration with the Moscow Region Ministry of Health to screen 26,000 pregnant women over two years. From these, 640 moderate to heavy drinkers and 640 controls will be selected for longitudinal follow-up including standardized physical exams and neurobehavioral testing of infants through twelve months of age. The specific aims of the project are: 1) To measure the birth prevalence and range of alcohol-related physical features and neurobehavioral impairment among children born to pregnant women in the Moscow Region who report consuming moderate to heavy amounts of alcohol by utilizing methods designed to permit earlier diagnosis of alcohol-related effects, and 2) To evaluate the contribution of maternal nutritional factors to increased risk for prenatal growth deficiency, neurobehavioral impairment, and alcohol-related physical features in infants prenatally exposed to moderate to heavy amounts of alcohol by conducting a randomized trial of a micronutrient supplementation intervention and measuring micronutrient levels in maternal blood. The proposed study will contribute to a better understanding of the incidence and range of FASD based on early diagnosis in a cross-cultural environment, and will for the first time specifically test a nutritional intervention that may have widespread applicability should undernutrition prove to be a modifiable risk factor for FASD.